Apligraf

Indicated For

venous leg ulcers, diabetic foot ulcers

About This Medication

# Charitable Assistance Program Patient Guide: How to Get Apligraf at Low or No Cost Apligraf is a **bilayered living skin construct** used to treat stalled **venous leg ulcers (VLUs)** and **diabetic foot ulcers (DFUs)** by promoting healing through living cells that restore normal wound functions.[1][6] The **Charitable Assistance Program** from Organogenesis helps **underinsured or uninsured patients with limited financial resources** access Apligraf at low or no cost by shipping it directly to patients who qualify.[5][9] ## About Apligraf Apligraf is not a traditional medication but a **living cellular skin substitute** made of human fibroblasts and keratinocytes in a collagen matrix, mimicking human skin.[1][4][6] It stimulates healing in chronic wounds that haven't improved with standard care. Applied by a healthcare provider, Apligraf activates keratinocytes at the wound edge, restores fibroblast function, normalizes extracellular matrix production, regulates growth factors, and reduces fibrosis.[1] Clinical evidence shows it helps close stalled VLUs and DFUs faster.[6] Each Apligraf is supplied ready for single-patient use and must be kept sealed to maintain cell viability.[4] Before treatment, wounds are prepared by debridement and optimized. After application, patients often see activated healing mechanisms within weeks.[1] Talk to your doctor to see if Apligraf is right for your VLU or DFU. ## Who Qualifies? This program targets patients facing financial barriers to Apligraf. Key qualifiers include: - **Underinsured or uninsured** individuals. - Those with **limited financial resources**.[5][9] While specific income thresholds are not publicly detailed, Organogenesis assesses financial need case-by-case, similar to many patient assistance programs (PAPs).[5][9] Medicare, Medicaid, commercial insurance, or no insurance patients may qualify if coverage is inadequate.[5] Providers can use Organogenesis' Circle of Care for benefit verification.[2][3][8] ## Income Eligibility Breakdown Detailed income limits are not specified online; eligibility is determined individually based on financial hardship.[5][9] Contact the program for a personalized assessment. Here's a general guide based on typical PAP structures (confirm with Organogenesis): | Household Size | Estimated Income Limit (300-400% FPL)* | Notes | |---|---|---| | 1 | $45,000 - $60,000 | Varies; proof of income required | | 2 | $60,000 - $80,000 | Assessed case-by-case | | 3 | $75,000 - $100,000 | Limited resources key factor | | 4 | $90,000 - $120,000 | Add ~$15,000-$20,000 per additional member | *Federal Poverty Level (FPL) approximations for 2026; actual criteria may differ. Call 1-888-432-5232 for exact details.[9] No income data? Explain your situation—hardship cases are considered.[5] ## Insurance Requirements The program serves **underinsured or uninsured patients with limited financial resources**.[5][9] - **Uninsured**: Fully eligible if financially needy. - **Underinsured**: Qualify if insurance denies coverage, has high copays, or doesn't cover Apligraf. - **Medicare/Medicaid**: Coverage varies by state; some require spenddown. Organogenesis helps verify benefits and appeals.[5][8] - **Commercial Insurance**: Use reimbursement support for prior authorizations.[8] Organogenesis' Benefit Verification/Prior Authorization (BV/PA) program checks coverage first.[5][8] If insurance pays partially, the PAP may cover the rest. ## Step-by-Step Application Process Applications can be submitted via **multiple methods**: phone, fax, or provider assistance.[9] 1. **Consult Your Doctor**: Discuss Apligraf suitability for your wound. They initiate via Circle of Care.[2][3] 2. **Contact Program**: Call **1-888-432-5232** (Reimbursement Hotline, option 3 for specialists) or fax 866-212-2888.[8][9] Email reimbursement@organo.com for questions.[8] 3. **Submit Application**: Provider or patient completes form (available via phone). Include proof of financial need, prescription, and wound diagnosis.[5][9] 4. **Benefit Verification**: Team checks insurance; handles prior auth if needed.[8] 5. **Approval Review**: Assessed for financial eligibility.[5] 6. **Receive Apligraf**: Shipped **directly to patient** or provider.[9] Start early—your provider can access tools from organogenesis.com.[2] ## Timeline and Delivery Processing time varies; expect **2-4 weeks** for approval based on typical PAPs, though not specified.[5] Reimbursement support responds quickly via hotline.[8] Once approved, Apligraf is **shipped to the patient** promptly to ensure viability.[4][9] Follow-up applications may be needed per treatment course. Track via phone.[9] ## Alternatives if Denied - **Appeal**: Request review with additional docs; Organogenesis assists.[8] - **State Programs**: Check Medicaid spenddown or local aid.[5] - **Other PAPs**: Search rxassist.org for similar wound care support.[7] - **Reimbursement Resources**: Coding/coverage tools for insurers.[5][8] - **Clinical Trials**: Ask provider about studies.[1] - **Generic/Other Products**: No biosimilars noted; discuss alternatives like other skin substitutes with your doctor. ## Disclaimer This guide is for informational purposes based on available Organogenesis resources as of 2026.[1][5][9] Eligibility, processes, and availability can change. It does not guarantee approval. Consult healthcare providers and call **1-888-432-5232** for personalized advice. Not medical advice—always follow doctor's instructions for Apligraf use.[4] Organogenesis reserves rights to program terms. (Word count: 1028)

Program information last verified: March 30, 2026